A study of patient satisfaction in the department of ENT with respect to facilities provided, social behaviours and overall satisfaction at district hospital, Belagavi

 

 

Abstract               Background: District hospitals have become important centres for providing health care in national health policies. Satisfaction levels of patients helps to assess the performance of health providers and plan effective remedial measures to improve the performance of the district hospital. Aim: To evaluate patient satisfaction in the department of ENT with respect to facilities provided social behaviors and overall satisfaction at District hospital, Balagavi. Material and Methods: This cross sectional study was conducted at ENT OPD at BIMS, District Hospital, Belagavi by using feedback forms in the form of a questionnaire. By random sampling, a total of 100 patients were included over a period of one month. Results: Overall 88.32% of patients was happy with the behaviour of staff and 11.66% was unhappy. 82% of patients were satisfied with the facilities provided. 39% patients were unhappy with the sanitary facilities provided and the overall cleanliness of the ENT OPD. Conclusion: majority patients seem to be satisfied with the services in ENT OPD, but there is a definite scope for further improvement.

Key Word: District hospital, ENT outpatient, facilities, behaviour, satisfaction

 

 

 

INTRODUCTION

Satisfaction of patients and general population is an important aspect in building the image of a hospital. It is also important for the hospital administration to know the problems faced and plan remedial measures to improve the functioning of the hospital.¹ District hospitals have become important centres for providing health care in national health policies. District hospitals are staffed with specialists to provide high quality curative care as well as preventive and promotive health care. Satisfaction levels of patients provide an effective feedback of penetration of various schemes implanted by national health programmes. This also helps to assess the performance of health providers and plan effective remedial measures to improve the performance of the district hospital.² The department of ENT is staffed with well qualified ENT specialists, audiologists, speech therapists, nursing and other paramedical staff. OPD services are departments where people first come in contact with the hospital and its facilities. Various services like diagnostic services, disability assessment, certification and rehabilitation, surgical treatments are provided free of cost to below poverty line (BPL) patients as well as APL patients at nominal cost. The ENT Department OPD also is a nodal centre for implementing the NPPCD programme run by Govt. of India, wherein new born children are screened for deafness and referred to higher centres whenever necessary. The present study was conducted to evaluate patient satisfaction in the department of ENT with respect to facilities provided social behaviors and overall satisfaction at District Hospital, Belagavi.

 

MATERIAL AND METHODS

This cross sectional study was conducted at ENT OPD at BIMS, District Hospital, Belagavi by using feedback forms in the form of a questionnaire. By random sampling, a total of 100 patients were included over a period of one month.

 

Inclusion criteria

• Patients attending ENT OPD at The BIMS, District Hospital, Belagavi
• Patients willing to participate in the study.

Exclusion criteria

• Persons not willing to participate.
• Patients with psycho-social and behavioural problems.

The factors considered while assessing the patient satisfaction were accessibility, waiting time, behaviour and performance of doctor, behaviour and performance of nursing and paramedical staff, facilities available, cleanliness, and adequate information and guidance regarding further course of management.

RESULTS

Out of the 100 patients included, 57 were male and 43 were females. Few patients i.e., 6% had difficulty in accessing the location of ENT OPD. Majority of the patients 42% had to wait for 30 min to 1 hour to attend in the OPD followed by 23% which were attended in less than 15 mins (Table 1).

 

Table 1: Accessibility and waiting time (n=100)

Overall 88.32% of patients was happy with the behaviour of staff and 11.66% was unhappy. 68%, 56% and 60% of the patients found good behaviour by doctors, nursing staff and paramedical staff respectively (Table 2).

 

Table 2: Behaviour (n=100)

Overall 82% of patients were satisfied with the facilities provided. Few patients requiring specialised services like BERA, OAE, and oncology had to be referred to higher centres. They were referred with proper instructions and

preferably under various schemes run by the state government. 39% patients were unhappy with the sanitary facilities provided and the overall cleanliness of the ENT OPD.

Table 3: Facilities provided (n=100)

In our study, overall satisfaction was 72%.

 

 

 

Table 4: Overall Satisfaction (n=100)

 

DISCUSSION

Patients are end users of health care facilities. Patient satisfaction surveys help in understanding the perception of the society of the service received and help in identifying problem areas and plan remedial measures. Patient satisfaction studies are common in higher centres especially in developed countries. Limited literature is available regarding assessment of ENT OPD services in India.³ In our study, we used a questionnaire to evaluate patient satisfaction. More than a decade ago, patient satisfaction questionnaires were developed by Ware, Snyder and Wright for the national centre for health services (NCHSR) which formed the basis for PSQ-III. The NCHSR project was carried out between 1972 and 1976 at the Southern Illinois University School of Medicine. Both internal consistency and test –retest methods were used to estimate the reliability of PSQ-II scales.⁴ In our study, overall satisfaction was 72% which is comparable to most of the previous studies. The 28% unsatisfied patients, the reasons for which have been improved upon. Poor patient satisfaction can lead to poor compliance to treatment and follow-up, resulting in poor health outcomes. Qureshi W and his colleagues had conducted a brief study on patient satisfaction at the Lal Ded hospital, Srinagar. Study sample of 1000 patients/ attendants were selected randomly in various sections of the hospital. Structured questions were asked to each of them and comments noted. The data collected was analysed by statisticians and inferences drawn. In the study 72% were satisfied with services provided.⁵ The ENT OPD is located in the main OPD block and most of the patients had no difficulty in accessing the location of the OPD. There is only one Unit functioning in the ENT department consisting of four staff. There are three Operation theatre days in week for which two staffs are posted on rotation basis. Also the staffs are burdened by certification duties; hence attention to patients with illness is at times delayed. Lack of triage area also delays attention to urgent treatment needed for patient with acute symptoms. Certain days of the week when the OPD attendance is more and the space becomes overcrowded, the behaviour of the doctors, nursing staff and paramedical staff gets hampered. But overall 88.32% of patients was happy with the behaviour of staff and 11.66% was unhappy. Rickets in his study highlighted the importance of lack of attention and communication by nursing staff, as an important aspect of patient satisfaction.⁶ Worthington K, a psychiatrist in the USA, revealed that patient satisfaction is not merely “smile and be nice” behaviour.⁷ The patient’s experience of care is more important and reflects on their response to the care provided. An effective customer service program needs vision, a long term commitment and constant surveillance. The sincerity and commitment of the hospital staff towards the care they provides to the patients, determines the success of any customer satisfaction service. The department of ENT is still in its developmental stages providing most of the basic ENT care. Certain diagnostic and therapeutic services are not available. But 82% of patients were satisfied with the facilities provided. Few patients requiring specialised services like BERA, OAE, and oncology had to be referred to higher centres. They were referred with proper instructions and preferably under various schemes run by the state government. The district hospital caters to large extent of rural population. Cleanliness is maintained by Class IV staffs which are mainly outsourced. Keeping the environment clean is not given importance as much needed. 39% patients were unhappy with the sanitary facilities provided and the overall cleanliness of the ENT OPD. Belagavi has a population which is multilingual. The number of aged and illiterate and people visiting are high. Majority felt the signage to be inadequate. The OPD numbering is also not sequential and patients had a difficulty in cross referral to other departments. The nursing and paramedical staffs take keen interest in guiding patients. In addition there at many social workers and MAY I HELP YOU desks, which help patients in their problems.

 

CONCLUSION

Patients attending the OPD services are an important component of hospital services. They are responsible for spreading the image of the hospital. Majority of the patients were satisfied with the services but regular feedback needs to be done to improve upon the performance and services provided. Delay in attending to patients and overcrowding can be avoided by having additional staff and junior doctors. Facilities like higher investigations need to be started at the earliest so that patients need not have to go to other hospitals. Adequate signage and directions in multiple languages need to place at proper locations to facilitate patient awareness. Existing personal can be trained in proper public relations. In overall conclusion, majority patients seem to be satisfied with the services in ENT OPD, but there is a definite scope for further improvement.

 

REFERENCES

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• Ware JE Jr, Snyder MK, Wright WR, Davies AR. Defining and measuring patient satisfaction with medical care. Eval Program Plann. 1983;6(3-4):247-63.
• Quereshi W, Naikoo GM, Baba AA, Jan F, Wani NA, Hassan G, Khan NA. Patient satisfaction at Tertiery Care Hospitals in Kashmir: A Study from The Lala Ded Hospital, Kashmir, India. The Internet Journal of Health. 2009; 8(2).
• Tom Ricketts RMN. General satisfaction and satisfaction with nursing communication on an adult psychiatric ward. Journal of Advanced Nursing 1996;24(3):479-487.
• Worthington K. Customer satisfaction in the emergency department. Emerg Med Clin North Am. 2004 Feb;22(1):87-102.